Exertional Rhabdomyolysis during a 246-km Continuous Running Race

Abstract

Muscle and liver damage indicators were elevated at the highest level ever reported as a result of prolonged exercise, although no severe symptoms that required hospitalization were observed in any of the participants. The data suggest that even moderate-intensity exercise of prolonged duration can induce asymptomatic exertional rhabdomyolysis.

12-hour ultra-marathons - Increasing worldwide participation and dominance of Europeans

“…Ultra-marathon running is of increasing popularity (Hoffman, 2010;Hoffman & Wegelin, 2009; Knechtle et al, 2011aKnechtle et al, , 2012aLepers, 2008Lepers, , 2010Skenderi et al, 2006). Participation in endurance sports showed a trend to longer events (Zaryski & Smith, 2005; Knechtle et al, 2011a), and new distances such as ultratriathlons (Knechtle et al, 2011a(Knechtle et al, , 2011b; Lepers et al, 2011;Sigg et al, 2012), which equate to a multiple of an Ironman triathlon, have been created to increase the availability for runners who are looking for yet harder challenges.…”

“…However, no study investigated participation and performance trends in 12-hour ultra-marathoners. More specifically, to date most of the studies investigated a particular running competition (Skenderi et al, 2006), a competition series (Brannen & Milroy, 2004;Hoffman, 2010;Hoffman et al, 2010;Hoffman & Wegelin, 2009), but no study collected and analyzed data of a whole competition series worldwide. Since the 12-hour run is a form of ultra-marathon or an ultraendurance sport event, the series of studies about ultra-endurance competition features a gap.…”

Branched-Chain Amino Acid Supplementation during a 100-km Ultra-Marathon^|^mdash;A Randomized Controlled Trial

“…In recent years, studies investigated athletes participating in ultra-marathons over 100 km ( 1 ) or even longer ( 2 , 3 ). Marathon and especially ultra-marathon running as an eccentric exercise may cause skeletal muscle damage resulting in an increase in myocellular enzymes such as plasma creatine kinase (1)(2)(3) and myoglobin ( 1 ). Skeletal muscle damage and the corresponding increase in myocellular enzymes in plasma may lead to rhabdomyolysis, thus causing an impairment of renal function ( 4 ), reflected by a decline in the post-race creatinine clearance ( 5 ) and even renal failure in ultra-marathoners ( 6 ).…”

Rabdomiólise induzida pelo exercício: biomarcadores, mecanismos fisiopatológicos e possibilidades terapêuticas

“…Trabalhos recentes realizados em seres humanos utilizando técnicas de biologia molecular avaliaram a presença de polimorfismos específicos, fato que poderia explicar porque existe uma grande variabilidade na resposta a um mesmo protocolo de exercício podendo levar ou não à rabdomiólise. 8,4,9 Clarkson e colaboradores 25 observaram que indivíduos homozigotos para o alelo MLCK (cadeia leve de miosina) do tipo 49T apresentaram maiores incrementos nas concentrações plasmáticas de CK e mioglobina, em resposta ao exercício excêntrico. Por outro lado, sujeitos heterozigotos para o alelo MLCK 3788A mostraram aumentos apenas para CK, sugerindo que portadores destes genótipos apresentam um maior risco para desenvolver rabdomiólise.…”

“…Valores maiores do que 5.000 UI/l estão associados com um maior risco para insuficiência renal. 3,4 Outras enzimas também podem estar presentes como transaminase glutâmico-pirúvica (TGP; EC 2.6.1.1), transaminase oxaloacética (TGO; EC 2.6.1.2) e lactato desidrogenase (LDH; EC 1.1.1.2.7). 1,3,4 Sua quantificação é muito empregada em diagnósticos clínicos, pois pode indicar a gravidade da lesão e origem do tecido lesionado.…”